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Municipalities should have complied with the Government Decree on swine flu vaccinations

Ombudsman received several complaints relating to the A (H1N1) influenza vaccine

11.6.2010

The Ombudsman received several complaints relating to the A (H1N1) influenza vaccine in late 2009.

The criticism made in five complaints was that the Government Decree concerning the arrangement of swine flu vaccinations and the order in which various population groups were to be vaccinated stipulated that the over-65 at-risk group was to be the second-last group to be vaccinated. The complainants took the view that the Government decision had glaringly violated the fundamental rights of elderly citizens.

Criticism in the other complaints was directed at the principles on the basis of which the City of Espoo failed to vaccinate some dentists as well as the fact that members of the Lahti Philharmonic Orchestra were vaccinated before at-risk groups.

Members of the Lahti Philharmonic Orchestra were vaccinated before at-risk groups, in contravention of the Decree

The City of Lahti social welfare and health department acted contrary to the Government Decree when members of the Lahti Philharmonic Orchestra were vaccinated against swine flu before at-risk groups.

The Ombudsman points out that the order of vaccination priority stipulated in the Decree was absolutely binding on municipalities and could not be deviated from. The purpose of the vaccination priority stipulated in the Decree was, according to the Ministry of Social Affairs and Health, to ensure that the population groups most susceptible to the severest forms of swine flu would be vaccinated first. A vaccination prioritisation had to be made, because supplies of the vaccine were obtained from abroad only in batches, and the decision on the order in which various groups were to be vaccinated was made on the basis of medical and epidemiological knowledge.

Some dentists in Espoo were denied vaccination on incorrect grounds

The City of Espoo acted unlawfully when it denied some dentists the A (H1N1) vaccine on the ground that they were working in a health centre under a supply arrangement. Ombudsman Petri Jääskeläinen points out that this ground was not compatible with the Government Decree.

According to the Government Decree, the first to be vaccinated were those health and social welfare personnel whose work involved directly treating infected patients or those exposed to infection. Dentists who treated patients of this kind were entitled to vaccination irrespective of whether they were in the employ of the City or working in a health centre as supply personnel.

The City of Espoo's vaccination practice was incompatible with the Government Decree also in that dentists in private practice were not vaccinated irrespective of what patients they actually treated. The Ombudsman found this solution on the part of the City schematic in character.

Was the number of saveable years of life the reason why sick persons over 65 were relegated to the end of the vaccination queue?

Ombudsman Petri Jääskeläinen asked the National Institute for Health and Welfare (THL) for a statement on the reasons why it had been decided to place over-65s who belonged to the at-risk group because of illness second last on the vaccination prioritisation list.

THL said in its statement that "[because] the vaccination is in short supply and if the disease causes mortality in both young and old people, a decision also has to be made as to whether to try to prevent merely death in these groups or whether the number of years of life saved is of significance. Saving the life of an aged person with a long-term illness does not save as many years of life as preventing the death of a school-age child would".

Saving years of life is not mentioned in the introductory memorandum for the Government Decree as a ground affecting the vaccination prioritisation, the Ombudsman points out.

In this respect, the Ombudsman has asked the Ministry of Social Affairs and Health for a report on whether the Government had correct and sufficient information available to it when it decided on the order of priority for vaccinating members of the over-65 at-risk group. In addition, he has asked the Ministry for a statement of position on whether the ground of saving years of life presented by THL can be considered acceptable. He expects the statement not later than 31.8.2010.

Additional info will be provided by Senior Legal Adviser Kaija Tanttinen-Laakkonen, tel. + 358 (0)9 4321.